Ultra-thin caliber endoscopes in daily practice: uses for therapeutic application
and beyond on the basis of review of 1028 procedures
#MMPMID26528492
Oterdoom LH
; Goet JC
; Jacobs MA
; Mulder CJ
Endosc Int Open
2015[Oct]; 3
(5
): E400-4
PMID26528492
show ga
BACKGROUND AND STUDY AIMS: Ultra-thin caliber endoscopes (UTCEs) are versatile
and applicable in various conditions. However, only limited data exist on the
actual daily clinical use of UTCEs. The aim of our study was to determine
indications for UTCEs in a large patient cohort. In turn, our 2 main objectives
were (1) to evaluate patient comfort and safety and (2) to determine benefits and
potential advantages associated with the use of UTCEs in this same cohort.
PATIENTS AND METHODS: We performed a retrospective analysis of our prospective
database of 1028 procedures with UTCEs in 457 patients. All procedures were
carried out in the Department of Gastroenterology and Hepatology, VU University
Medical Center, in Amsterdam, the Netherlands, between May 2008 and May 2014.?In
these procedures, either the Fujinon (Tokyo, Japan) EG-530N UTCE or the Olympus
(Tokyo, Japan) GIF N-180 UTCE was used. RESULTS: Mean (standard deviation [SD])
age of patients was 64 (20) years, and most (60?%) of the patients were men. Most
(61?%) of the underlying diseases, requiring endoscopic procedures, were found in
the esophagus. Of the procedures performed, 91?% were successful, and 82?% were
therapeutic. In comparison with regular endoscopes, the most important advantage
of the UTCE was the ability to pass a stenosis (37?%), followed by nasogastric
feeding tube placement (13?%). Newer and more innovative uses of the UTCE were
percutaneous endoscopic gastrostomy (PEG)-jejunal extension placement with
endoscope introduction through existing PEG tract, retrograde esophageal
introduction through existing PEG tract, inspection of colonic neovagina
stenosis, and direct inspection of the common bile duct. CONCLUSIONS: In everyday
clinical practice, the UTCE has specific advantages over conventional endoscopes
because of its small caliber.?The 3 main advantages are (1) introduction of
high-grade strictures; (2) introduction of fistulas, including PEG fistula; and
(3) increased patient comfort. The endoscopist should appreciate these advantages
and consider use of the UTCE accordingly.
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